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21 Cards in this Set
- Front
- Back
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Medication for HIV
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*goal is:
- slow replication of the virus - suppressing, preventing or stopping opportunistic infections - boost the immune system *some MD's hit hard with combo therapy as soon as dx is made, some wait until CD4 levels drop below 500 d/t problems with drug resistence |
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What is safer sex?
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*solitary masturbation
*fantasy *mutually monogamous relationship with a noninfected partner in which both partners have been negative HIV tests 3 months apart |
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Other tests
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*Quantative RNA Assays-3 types
- RT-polymerase chain reactors (RT-PCR) - Branched DNA method (bDNA) - nucleic acid sequence based assay (NASBA) *all 3 use gene amplification process; 100% specific; used for disease management and to dx HIV |
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Diagnostic evaluation of HIV tests
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*after infection, it takes 3 weeks to 3 months to test positive for HIV antibodies
*ELISA- detects the presence of antibody *Western Blot- done if ELISA+ detects serum antibodies to 4 specific major HIV antigens; considered + if 2 are present |
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What kind of isolation is a person with HIV put in?
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Blood & body fluid precautions (standard precautions)
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What is difference between confidential vs. anonymous test?
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Confidential- name is on test
Anonymous- name is not on test (can buy these at Walgreens) |
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You are stuck with a needle of a patient who has not been HIV tested, what do you do?
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*Wash hands (don't squeeze)
*tell manager *go to ER, get tested, begin viral meds *explain HIV testing to pt; get dr. order; if pt says 'no' there is nothing you can do |
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Retrovirus
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*they only have RNA and they have reverse transcriptase (RT) an enzyme that makes them more efficient at replicating (1 virus particle can replicate 250 times)
*Retrovirus include: HIV1, HIV2, HTLV 1 (adult T cell leukemia-lymphoma) HTLV II (hairy cell leukemia) HTLV (cutaneous T cell lymphoma) |
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Lymphocytes
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*defend the body- two types
B cells change into plasma cells and secrete antibodies (humoral immunity) T cells attack an antigen directly (cell mediated immunity) *2 groups of T cells are important in HIV -T4 cells (CD4 or helper T cells) are vunerable to HIV -T8 cells (CD8 or supressor T cells) inhibit the immune response |
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What defines AIDS?
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*HIV positive
*CD4+ T-lymphocyte (T4) count below 200/mm3 or *CD4+ T-lymphocyte total percentage below 14 |
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Immunodeficient people that do not have HIV or AIDS?
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oncology pts, elderly, babies
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Protease Inhibitors
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*they inhibit the activity of HIV protease, an enzyme essential for replication. Inhibiting HIV protease leaves the viral particles non-infectious
*s/e: ^blood glucose and diabetes, fat accumulation, diarrhea, and ^cholesterol |
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Nucleoside analogue reverse transcriptate inhibitors (NARTI)
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*slow the replication of HIV by blocking the RT enzyme. Without RT, the HIV virus does not replicate
*s/e: liver dysfunction, n/v, HA, insomnia, peripheral neuropathy, neutropenia, seizures, lethargy |
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What is safe sex?
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*mutual masterbation
*wearing a latex glove when exploring rectum or vagina *closed-mouth kissing *massage *hugging *body to body rubbing |
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Best ward to place HIV/ AIDS on?
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oncology...others are already immunosuppressed
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Non-nucleoside reverse transcriptase inhibitors (NNRTI)
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*inhibit replication of HIV by blocking RT enzyme. By changing the RT it becomes inactive
*s/e: liver dysfunction, HA, rash, dizziness, nightmares, n/v, diarrhea, fatigue, neutropenia |
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HIV/AIDS, what to assess?
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*Immunologic (<WBC, night sweats, fever
*integumentary (poor healing wounds, Karposi's sarcoma, Herpes) *respiratory (Mucous membrnes, candida infections, swollen lymph nodes, sores in mouth, bleeding gums) *gastrointestinal *CNS (baseline mental status) *opportunistic infections (H. pylori-ulcers) *malignancies (cancers) *AIDS dementia complex (<LOC, confusion) *wasting syndrome (thin, emancipated) |
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Opportunistic Infections
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*Protozoal infections (pneumocystis carinii pneumonia, toxoplasmosis, cryptosporiosis, isoporiasis) *fungal infections (candidiasis, histoplasmosis, crytococcosis) *bacterial infections (myobacterium avium-intracellulare complex, TB) *viral infections (cytomegalovirus, herpes simplex, varicella-zoster)
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Malignancies
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*Karposi's sarcoma
*Non-Hodgkins lymphoma *Hodgkin's lymphoma *Invasive cervical carcinoma |
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Therapeutic interventions
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*education *drug therapies *comfort
*social isolation *support *nutrition *skin/mouth care *quality of life *prevent infections *complementary therapy *spiritual support *sex education |
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Other tests
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Viral Load Testing - measures the presence of HIV viral genetic material (RNA) or another actual viral protein in the persons blood. Quantitative and very useful in monitoring disease progression and treatment effectiveness
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